Abstract
Rationale: Increased thickness of the airway smooth muscle (ASM) layer in asthma may result from hyperplasia or hypertrophy of muscle cells or increased extracellular matrix (ECM).Objectives: To relate ASM hypertrophy, ASM hyperplasia, and deposition of ECM to the severity and duration of asthma.Methods: Airways from control subjects (n = 51) and from cases of nonfatal (n = 49) and fatal (n = 55) asthma were examined postmortem. Mean ASM cell volume (VC), the number of ASM cells per length of airway (NL), and the volume fraction of extracellular matrix (fECM) within the ASM layer were estimated. Comparisons between subject groups were made on the basis of general linear regression models.Measurements and Main Results: Mean VC was increased in the large airways of cases of nonfatal asthma (P = 0.015) and fatal asthma (P < 0.001) compared with control subjects. NL was similar in nonfatal cases and control subjects but increased in large (P < 0.001), medium (P < 0.001), and small (P = 0.034) airways of cases...
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